What caused Calif. man's death during third-molar surgery?

2013 04 12 13 26 41 291 Question Mark 200

Authorities are looking into a San Diego man's death last month during what was considered a routine third-molar extraction procedure.

On March 21, Marek Lapinski, 24, underwent surgery in the care of Steven Paul, DDS, an oral and maxillofacial surgeon in Temecula, CA. In the midst of the surgery, Lapinski began to cough, was administered propofol, and subsequently went into cardiac arrest, according to news reports. Paramedics were called, they attempted to intubate him, and he was transported to a nearby hospital and placed in intensive care. He died on March 24.

Now state and local authorities -- along with the young man's family -- are trying to determine what caused his death.

A nurse at the hospital reportedly told the family that Marek was given too much anesthetic, and a pulmonary doctor said it appeared to be a case of an overdose, according to Fox 5 San Diego.

“There were no apparent contraindications for his oral surgery.”
— Clark Hudson, attorney for
     Steven Paul, DDS

However, the ambulance report shows that when the paramedics attempted to intubate Lapinski, they found two pieces of gauze in his throat.

After reviewing his medical records, Natalie Lapinski -- Marek's sister and a nurse -- told Fox 5 that at least six different sedatives were administered by Dr. Paul. "Complications developed approximately 30 minutes into the procedure," the family noted on a website set up after his death.

According to the medical records, Lapinski was administered 43 mg of propofol after he began coughing during the procedure, Natalie told Fox 5. In addition, Dr. Paul's instruments measured a 99% oxygen saturation level every five minutes throughout the first 20 minutes of surgery. At the 25-minute mark, there was no register, while the final entry registered at 43%.

Natalie said she was alarmed to learn that Marek may have been without oxygen for 10 minutes and questioned whether he had been properly monitored.

In an email to DrBicuspid.com, Clark Hudson, attorney for Dr. Paul, stated, "The circumstances regarding Mr. Lapinski's complications are not completely understood. Mr. Lapinski's complications occurred despite the fact there were no apparent contraindications for his oral surgery, routine anesthetic medications were being used for the procedure, and immediate measures were undertaken to revive the patient as soon as the patient began to decompensate."

The Dental Board of California has launched an investigation into Lapinski's death, and the Los Angeles County coroner's office said it will issue an autopsy report in eight to 10 weeks.

"Unfortunately, there is considerable speculation, misinformation, and blame surrounding Mr. Lapinski's complications," Hudson noted. "The loss to Mr. Lapinski's family obviously cannot be overstated. What is easily overlooked is the devastating impact the doctor, and his surgical team, suffer when a tragedy such as this occurs. Even though the oral surgical team is trained to handle unexpected medical emergencies, nothing can prepare them for the personal emotional toll when the event turns fatal."

Lapinski was the vice president and a founding partner of San Diego-based Tactical 3D Dimensions, a company that develops software and hardware for night vision devices.

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